The decision by the United States to cut millions of dollars in funding for South Africa’s HIV/Aids programmes while simultaneously prioritising resettlement of white Afrikaners underscores the Trump administration’s hostile attitude towards the republic.
In September this year, the administration told US representatives that it planned to limit the number of refugees admitted to the US in 2027 to mostly white South Africans.
In its notice to Congress, it announced that it intended to spend about $500 million to resettle the new arrivals next year.
For those living with HIV in South Africa, this measure will have added salt to an already gaping wound.
Between 2003 and February 2025, funding from the US President’s Emergency Plan for AIDS Relief (PEPFAR) ranged between $400 million and $470 million per year – notably not far off the 2027 resettlement budget.
Trump’s decision to abruptly withdrew PEPFAR and USAID funding affected some 70% of South African healthcare facilities.
Furthermore, in late 2025 the US shut South Africa out of its foreign funding for the ground-breaking six-monthly HIV prevention jab, which all but guarantees that HIV-negative people will not contract the virus.
US pharmaceutical giant Gilead Sciences, the manufacturer and patent holder, initially only promised 30 000 doses to South Africa so as not to draw the ire of Washington.
This number has subsequently been increased to 450 000 doses following a public outcry, though in a nation where eight million people still live with HIV it will barely make a dent.
Ironically, revered South African physician-scientist Linda Gail Bekker had led one of the key clinical phases while trialling the drug.
“The beautiful plan that we had in 2024 was that PEPFAR would purchase all 10 million doses and would make sure that it was available to PEPFAR countries,” Bekker said.
Noma-Roma Ludidi-Ndabande, the Eastern Cape chairperson of PLHIV Sector, an umbrella body for five organisations working with HIV patients, said the US cuts had badly affected communities across the province.
“The (HIV) clients are falling behind on their treatment and we are getting many defaulters now. This creates the risk of more people dying,” she said.
She also pointed out that staff dealing with HIV patients were under a lot more pressure due to retrenchments at treatment centres.
This had the knock-on effect of impacting their mental health.
Ludidi-Ndabande hoped that the Democrats winning both US houses of Congress would pave the way for PEPFAR and USAID funding to be restored.
It is lost on few people that in the same month Trump announced the funding cuts, he also declared that the US would be accepting Afrikaners as refugees.
According to US State Department figures from August 31 2026, more than 13,000 South Africans, mostly Afrikaners, had been admitted as refugees on the basis of being “victims of government-sponsored race-based discrimination” and false claims of “genocide”.
Yet this number remains a drop in the ocean if one considers that most of South Africa’s 2.7-2.8 million white Afrikaners have chosen to stay in the country.
The Trump administration’s policies have brought into sharp focus questions of whose lives matter more – and why – to the US government.
Irvin Jim, secretary general of the National Union of Metal Workers South Africa, is in no doubt as to the answer.
“The hesitation by lots of white Afrikaners to take up the US’s refugee resettlement policy is grassroots confirmation that plain old-school racism – not humanitarian mercy – is driving the Trump administration’s obsession to punish South Africa’s government,” Jim said.
It is widely held that one of Trump’s chief motivators for attempting to undermine and ostracise South Africa stems from its case against Israel before the International Court of Justice in late 2023.
Political commentators suggest that the administration is trying to portray South Africa as a country that is not in any position to judge other nations on their human rights records when its own is cause for alarm.
Jim pointed out that if slashing PEPFAR and USAID HIV money by the US was based on a genuine desire to save American taxpayers' money, it would not make sense to redirect it to “dubious” foreign policy projects like the white Afrikaner refugee resettlement drive.
He firmly believes it is no coincidence that the same February order that prioritised Afrikaner resettlement was the same month that US aid to South Africa was slashed.
While Yasin Kakande, a US-based author, TED speaker and Africanist, acknowledges there is a legal basis for refugee prioritisation in America, the fast-tracking of Afrikaners for asylum has been out of the ordinary.
“On average, processing a refugee claim takes 12 to 24 months in the US. Afrikaner resettlement is moving unusually fast.”
Kakande has even considered whether part of the money pulled from HIV funding in South Africa has been redirected to the resettlement programme.
Speaking in his personal capacity as an academic, Tatenda Chatikobo, a research fellow at the University of Warwick's School of Law, said as valid as human rights concerns were, the obligation for Washington to fund another country’s HIV programme was discretionary.
However, Chatikobo, who co-authored the widely-cited BMJ Global Health article “Colonialism in the new digital health agenda”, said there was a “big moral concern to be expressed here”.
“Instant cuts to big multilateral public health funding infrastructure developed over years is devastating for the very poor.”